OT: My Mom is losing her memory and I need advice

[Tbonewannabe]

Hello family,

Needing advice for a tough subject. My Mom's memory is starting to leave and my Dad doesn't know what exactly to do. She has been in and out of the hospital for various things (hip replacement then rehab, then fell and broke her leg right below the knee and more rehab along with fighting infections).

My Dad has been mentioning her memory is going. I live in Atlanta (they are in Northeast Mississippi) so I am not around her enough to recognize how bad it has gotten. I have noticed little things that seem off but just chalked it up to being in the hospital and getting old.

My Dad thinks that the government will basically take everything from him if he has to put her in a facility to take care of her. I have no clue about any of this and am just now starting to research. I figure that I will eventually have to get a lawyer involved but wanted any advice that anyone can give.

Thanks for any help.

[Catfish]

Sorry about your mom. Prayers for your family.

[Vandownbytheriver]

Why would the government take their property if he puts her in a long term care facility?

[starkvegasdawg]

Why would the government take their property if he puts her in a long term care facility?

Because a lot of times insurance won't pay for that until all means to pay for it yourself are gone. That means life savings, your house you can sale, etc. It's bullshit what they can make you do. Basically have to be flat broke before Medicare kicks in. At least it used to be that way. It's why my mom put a lot of property in my name so if she ever had to do that they couldn't take it.

[Quaoarsking]

Because a lot of times insurance won't pay for that until all means to pay for it yourself are gone. That means life savings, your house you can sale, etc. It's bullshit what they can make you do. Basically have to be flat broke before Medicare kicks in. At least it used to be that way. It's why my mom put a lot of property in my name so if she ever had to do that they couldn't take it.

I believe you're referring to Medicaid, not Medicare.

[Leeshouldveflanked]

Because a lot of times insurance won't pay for that until all means to pay for it yourself are gone. That means life savings, your house you can sale, etc. It's bullshit what they can make you do. Basically have to be flat broke before Medicare kicks in. At least it used to be that way. It's why my mom put a lot of property in my name so if she ever had to do that they couldn't take it.
I think you have to have property transferred out of your name 7 years before you apply for Medicaid. Medicare wouldn?t pay for any long term care for my dad, so we had to do a ?swing bed? setup. He passed away before we were going to have to sell his house and land to pay for long term care.

[Martianlander]

Because a lot of times insurance won't pay for that until all means to pay for it yourself are gone. That means life savings, your house you can sale, etc. It's bullshit what they can make you do. Basically have to be flat broke before Medicare kicks in. At least it used to be that way. It's why my mom put a lot of property in my name so if she ever had to do that they couldn't take it.

It's wise that she did that. It also has to be out of her name for a certain period of time. Seems like it's around two years but don't hold me to that. Tbone I would consult an attorney immediately to see what your options are. Seems like the government swoops in when people are the most vulnerable. Prayers for your mother and I hope everything turns out for the best.

[Tater]

Why would the government take their property if he puts her in a long term care facility?

Because this is America and you can do everything right your whole life but if you get sick and have medical bills you are absolutely ****ed. We're a 3rd world country with how we treat healthcare. If the government would get its head out of corporate donors crotch's then we'd actually be able to have real discourse in this country. But as it stands you gotta have a job to not get ****ed on health insurance and even that's not enough. Source: My father who worked two jobs had the family bankrupt within 2 years when he got sick. Lots wasn't covered due to pre existing conditions that stemmed from a childhood illness. Life insurance was shit too.

Medical industry sucks. I'd almost suggest getting divorced and having her sign away all property to him. (It just matters to government and insurance anyways. **** it.) Have a lawyer draw it up. And when she goes, don't accept any of the debt. They'll try to trick you (both husband and son) into it. Don't do it.

[Vandownbytheriver]

I had no idea that it worked that way. That is insane they can just take all of your property like that.

I have BCBS insurance and besides the prescription benefits, it sucks. Almost a $2000 deductible before it pays anything. I despise having to pay for insurance.

[Cooterpoot]

Move everything she's got out of her name. That's what my dad did. He gave everything to all of us before he got to bad to do anything. All they get is their government check at that point. But nice facilities cost a fortune. So be prepared to pay for a nice place.

[Commercecomet24]

Move everything she's got out of her name. That's what my dad did. He gave everything to all of us before he got to bad to do anything. All they get is their government check at that point.

This is the only way to do it, otherwise they'll take it all. Went through it with my father in law and mother in law.

[Cooterpoot]

And I'll say, let her stay home as long as possible. No nursing home will ever be good enough for her or you. Moved my dad a couple times. Most affordable places are deplorable. I support people being able to end their lives after watching it all develop. The way our older people are treated is beyond comprehension.

[Commercecomet24]

And I'll say, let her stay home as long as possible. No nursing home will ever be good enough for her or you. Moved my dad a couple times. Most affordable places are deplorable. I support people being able to end their lives after watching it all develop. The way our older people are treated is beyond comprehension.

Amen to that!

[parabrave]

And I'll say, let her stay home as long as possible. No nursing home will ever be good enough for her or you. Moved my dad a couple times. Most affordable places are deplorable. I support people being able to end their lives after watching it all develop. The way our older people are treated is beyond comprehension.

As long as you can/ I went through Aunts and Uncles with Demintia and Alzheimers. Keep them in a familiar place as long as possible.

[99jc]

I went through Alzheimer's with my dad and dementia with my mom. On Christmas day a few weeks ago my wife's father died while we were with him...i couldn't revive him he had a massive heart attack. Now my mother-in-law lives with us and i am in hell and she is the devil. she is mean with dementia / Memory loss. Get everything out of their name and i mean tomorrow. Do quick sell on everything put it in your name. You have to make them look poverty level on the surface. go to an estate lawyer and get everything set up. make sure you get your dad to sign everything over to you as power of attorney. I can't express how quickly you need to get this done. I feel for you brother.... been there doing that again!

[Homedawg]

Hello family,

Needing advice for a tough subject. My Mom's memory is starting to leave and my Dad doesn't know what exactly to do. She has been in and out of the hospital for various things (hip replacement then rehab, then fell and broke her leg right below the knee and more rehab along with fighting infections).

My Dad has been mentioning her memory is going. I live in Atlanta (they are in Northeast Mississippi) so I am not around her enough to recognize how bad it has gotten. I have noticed little things that seem off but just chalked it up to being in the hospital and getting old.

My Dad thinks that the government will basically take everything from him if he has to put her in a facility to take care of her. I have no clue about any of this and am just now starting to research. I figure that I will eventually have to get a lawyer involved but wanted any advice that anyone can give.

Thanks for any help.

He's going to have to pay for it until she runs out of assets before she goes on Medicaid. Sucks but is what it is.

[Homedawg]

Move everything she's got out of her name. That's what my dad did. He gave everything to all of us before he got to bad to do anything. All they get is their government check at that point. But nice facilities cost a fortune. So be prepared to pay for a nice place.

It might work. But they are going to go back at least 3 years. Supposed to be 5 but they stopped at 3 w my grandmother. But this advice is certainly correct. Can't hurt. Night not work but can't hurt.

[Saltydog]

Currently going thru something similar with my parents! It?s a hard thing to do but I recommend everyone doing some estate planning and getting a will and living trust set up in your early to mid 60?s! DO NOT wait until it?s too late! Yes, it?s hard to accept that if you live long enough that everything you?ve ever worked for is no longer yours but it?s better than Uncle Sam getting it! We set up a trust for my folks a few years back but it?s not legally transferred til 7 years has past! Oh yeah, don?t try hiding it in a safety deposit box at any bank they do business with! Get a safety box in your name and put it in there! I?m no expert but I can tell you the options are limited and the guv has closed most loop holes! Money is tough to hide!

[msstatelp1]

Look into a Living Trust. There are ways to set it up to avoid the problems you're facing. My Mom has Alzheimers complicated by Parkinsons and this is the way my Dad has set things up for when she needs institutionalized care. It also has the advantage of avoiding Probate when they die as the only change to the trust will be me becoming the Trustee.

[Bass Chaser]

I’ve been and am going through this. I’ll respond in the morning.

[Apoplectic]

There are some studies that show that ketones either endogenous or exogenous can not only slow but reverse late stage mental issues. Get on pubmed and dig around.

[BoomBoom]

Hello family,

Needing advice for a tough subject. My Mom's memory is starting to leave and my Dad doesn't know what exactly to do. She has been in and out of the hospital for various things (hip replacement then rehab, then fell and broke her leg right below the knee and more rehab along with fighting infections).

My Dad has been mentioning her memory is going. I live in Atlanta (they are in Northeast Mississippi) so I am not around her enough to recognize how bad it has gotten. I have noticed little things that seem off but just chalked it up to being in the hospital and getting old.

My Dad thinks that the government will basically take everything from him if he has to put her in a facility to take care of her. I have no clue about any of this and am just now starting to research. I figure that I will eventually have to get a lawyer involved but wanted any advice that anyone can give.

Thanks for any help.

Sorry you are going through this. My mother's battle with Alzheimer's just ended this past summer. It sucks, and will only get worse, but at least it gives you time.

One piece of advice i can give is to not forget to think of your Dad through this as well. Often the caregiver will drive themselves into an early grave by spending so much effort on the spouse. Do what you can to ease his burden. Also explore your options for part time home care to give him regular breaks.

[Dawgbite]

Talk to an attorney who specializes in estate planning next week. Don’t wait. When my Dad passed away he left instructions for us to buy a long term care insurance policy for my mom. He had started researching it but ran out of time. It was expensive and wasn’t something we would have done without his wishes but when the time came it was a relief to know she had it. She only lived about 16 months in assisted living but it was a major relief knowing that financially she was taken care of. I know it’s too late for your mother but it might be something to consider for your father.

[viverlibre]

Assuming there is no LTC insurance, consult an estate planning attorney immediately. There is correct and incorrect information in this thread.

Don't start transferring assets until you consult an estate planning attorney. It can get complicated quickly, medicaid has a 5 year look back period, so you may have to wait until 5 years after transferring assets before medicaid eligibility, if that is necessary.

[Cooterpoot]

It might work. But they are going to go back at least 3 years. Supposed to be 5 but they stopped at 3 w my grandmother. But this advice is certainly correct. Can't hurt. Night not work but can't hurt.

Nothing they can do if everything is sold. We sold everything we couldn't hide. And we used an attorney in Hattiesburg to get it handled. It worked. Not only that, but the nursing home had to refund us money in the end for not handling things appropriately.
We filed a lawsuit at one place where a crack head work beat him up. Got money there too.
It's as shitastic as life gets. I don't wish it for anyone. Hope I kill over before then.
As soon as something is amiss with them, make the move to avoid issues people are mentioning.

[yjnkdawg]

Currently going thru something similar with my parents! It?s a hard thing to do but I recommend everyone doing some estate planning and getting a will and living trust set up in your early to mid 60?s! DO NOT wait until it?s too late! Yes, it?s hard to accept that if you live long enough that everything you?ve ever worked for is no longer yours but it?s better than Uncle Sam getting it! We set up a trust for my folks a few years back but it?s not legally transferred til 7 years has past! Oh yeah, don?t try hiding it in a safety deposit box at any bank they do business with! Get a safety box in your name and put it in there! I?m no expert but I can tell you the options are limited and the guv has closed most loop holes! Money is tough to hide!

A will or trust won't work with Medicaid, because it will have to be prorated after the time of death, and It will just start that 5 year look back period that Homedawg mentioned. Been through all of this with a lawyer and and an expert consultant on Medicaid.

[yjnkdawg]

I'm sorry you are going through this, and I wish ya'll the best. My Dad passed away in an assisted living facility this past March and my Mom has been in a nursing home since April of 2020. The nursing home has been costing at least $7000 a month (the price fluctuates on what the government tells them to charge a month) and the government has not paid anything on her stay. Homedawg is 100% correct on Medicaid. Medicaid has a five year look back period. So if you are deeded the property during that time from your Mom or Dad, it is not protected from Medicaid. Any Medicaid approval has to be after that 5 year look back period has ended before you can use Medicaid and still keep the property. Other assets such as CD's, Stocks, Mutual Funds etc. can not be transferred during that 5 year look back period, and it doesn't even matter if your name is on any accounts. I was deeded the farm property and the home, and the five year look back period will be over the later part of April this year. I have been told by an Attorney and a consultant that is considered an expert on Medicaid, and knows the ins and outs, on what you can do or not do, that the land will be safe after that date. If I had been willed the land it would not have been, because when the will is prorated that just starts the five year Medicaid look back period. My suggestion would be to talk with an attorney or somebody like I have that knows the ends and out on what you can do and not do concerning Medicaid coverage. Like an attorney friend told me, you work basically all of your life and try to save up some money , and then health issues come into play and the government wants you to spend pretty much everything you have before Medicaid is an option. It sux but that's the way the government works.

[Dawg_Lover]

At the age, of 95, my mother had a stroke, leaving her completely disabled. Sixteen years prior, I had sold my home, moved and changed jobs to look after her, her home, and 3 acres of land.

Even though the doctor told me I had no choice, I knew this time I could not physically do it, and the nursing home was our only option. The hospital assigned the nursing home here, in NW MS, which fortunately was, and still is, the best run one in the area. Very few can afford to pay out of pocket, and long term care does not usually cover it all. She, nor I, could afford to cover the costs. Our only option was through Medicaid.

Thankfully, I already had legal power of attorney, had been handling all her finances for years. Plus, 7 years prior she had her attorney draw up a Will, with a Property Quit Claim Deed included, so that when she drew her last breath all property would automatically go into my name. Because I was not a spouse, or dependent, if the quit claim had been done in under 6 years the state could have legally claimed her property, and I would have been without a home right then and there.

Every state?s laws are different. If I remember correctly, in MS, if a person is admitted under Medicaid, and their spouse is still living, in the residence, then the spouse is allowed to stay there as long as they are able, or die while living there. Then, the state claims the estate.

If need be, you can try either contacting their Regional Medicaid office to see if they will mail you the state requirements, or Google MS Medicaid to possibly find it.

The other option would be to seek advice from an in-state elder law attorney.

Once an Alzheimers patient is past the early stages, I do not agree with trying to keep them in the home. I know this from observing my Mom trying to care for my Dad, with Alzheimers, before his passing. It was devastatingly difficult mentally and physically on her. My closest friend now has her husband, with Alzheimers, in a memory care home. He became too dangerous for her to look after alone.

But, even if they are docile, unless you have been close to that situation, you have no clue how exhausting, in every possible way, it is. Two couples, who were close to me, dealt with Alzheimers. In both cases, it was the husband looking after the wife, and both of the husbands died well before their wives. That is very common.

No one can understand, unless they have had some hands-on experience with Alzheimers patients for extended periods of time. Try to imagine continual sleep deprivation because many roam throughout the night, often finding ways to get out. And, of course, you can never let them out of sight day or night, or leave car keys, knives, or scissors accessible. You might find a stove eye turned on high, maybe with a dry pot or one with food left on it. Or, a ironing board with a hot iron left on & laying flat on the board. My father once found his truck keys that Mom thought were well hidden. All of us, as well as local authorities, wound up searching for him for hours. We were fortunate that he was located before he hurt himself, or worse someone else. Just answering the same questions for hours on end can try the patience of a saint. Years ago I knew of a family down on the coast looking after a relative, with Alzheimers, in their home. As I understood it, he was very docile and amiable. They said one Saturday, some of the family were in their den talking, when the relative said he was going to the kitchen for a glass of water. They thought nothing of it because it was something he had still been able to do for himself. Shortly after they heard him coughing and gagging. He had gone in a cabinet, found a random bottle of liquid, poured a glass and drank it. It was bleach. He died. They were devastated.

That makes my point. It is virtually impossible to watch someone every minute, 24 hours a day, every day of the year. You cannot anticipate their every move or thought. You cannot have patience all of the time. Or, it will kill you trying.

[yjnkdawg]

Nothing they can do if everything is sold. We sold everything we couldn't hide. And we used an attorney in Hattiesburg to get it handled. It worked. Not only that, but the nursing home had to refund us money in the end for not handling things appropriately.
We filed a lawsuit at one place where a crack head work beat him up. Got money there too.
It's as shitastic as life gets. I don't wish it for anyone. Hope I kill over before then.
As soon as something is amiss with them, make the move to avoid issues people are mentioning.

Glad it worked out for you.

[Dawg_Lover]

One more thing, does your mother have a living will? My mother did, and paraphrasing here, but hers stated her wishes which were should there be no chance, for quality of life, she wanted no lifesaving measures administered whatsoever. Following her stroke, she instructed me to put it immediately on file with the nursing home. The attending doctor said that was one of the most important documents for them to have on file regarding their patients.
I do not know the cognizance, of your mother, but if she does not have one, and can understand the concept, I would advise completing one asap.

[grinnindawg]

Find a competent lawyer.
Some of the advice being given on here was not legal 20y ago. The 1st adviser we sought gave some of it.
The Elder lawyers(Huntsville AL) and 2nd financial adviser we saw said it was not legal.

Find a doctor that cares about your mom being comfortable. Full stop.
Docs had my dad on Warfarin.
Found a good doc that took him off that and put him on 1/2 baby aspirin a day.

If they don't already have one, get a living will and DNR. It can help in some situations.
Even so, DNRs meant nothing in our ER. The ER will try and save them.
A hospitalist finally took over and put dad on Hospice.
People who have never been through it can think this callous. They do not understand.

Find some way to relieve stress each day.
Pray, meditate, exercise....
Find a way for your dad to get away for at least an hour or so at times.

Be extra nice and patient with family and care givers.
There is no reason to make an already horrendously stressful situation worse.
Wish we'd always done this.

Depending on the progression, learn to enjoy talking about things that happened long ago.
Often they can remember those. Talking about them seemed to calm dad.

Visit care facilities between 9 and 11. Notice how the residents are being cared for.

If your mom has any monthly income, miraculously care facilities often charge almost all of that.
Almost like there's a correlation there. It may not be as bleak as your dad believes.

Hope this helps.

[Johnson85]

I had no idea that it worked that way. That is insane they can just take all of your property like that.

I have BCBS insurance and besides the prescription benefits, it sucks. Almost a $2000 deductible before it pays anything. I despise having to pay for insurance.

They can't "take your property". They charge you for providing assisted living. It's pretty simple when you're single. You pay for care as long as you can, and if you ever don't have enough money to pay, Medicaid will pay. The "lookback" rules people are referencing are to make sure people needing assisted living don't give away their property to push the costs for their care onto taxpayers before they run out of money. That is all straightforward enough and eminently fair.

It gets complicated when you are married, as if you don't plan well, you can easily have a couple that saved diligently and have enough assets to live an upper middle class life in retirement, but don't have enough to cover $100k a year for one spouse while also maintaining the primary home and living expenses of the independent spouse. In those situations, one spouse needing assisted living can result in both spouses ending up with essentially nothing beyond a homestead and some pretty modest exempt income. I don't think you should really be forced to scramble more than one half the nest egg to care for a spouse, but that's an almost impossible standard to enforce.

[Tater]

They can't "take your property". They charge you for providing assisted living. It's pretty simple when you're single. You pay for care as long as you can, and if you ever don't have enough money to pay, Medicaid will pay. The "lookback" rules people are referencing are to make sure people needing assisted living don't give away their property to push the costs for their care onto taxpayers before they run out of money. That is all straightforward enough and eminently fair.

It gets complicated when you are married, as if you don't plan well, you can easily have a couple that saved diligently and have enough assets to live an upper middle class life in retirement, but don't have enough to cover $100k a year for one spouse while also maintaining the primary home and living expenses of the independent spouse. In those situations, one spouse needing assisted living can result in both spouses ending up with essentially nothing beyond a homestead and some pretty modest exempt income. I don't think you should really be forced to scramble more than one half the nest egg to care for a spouse, but that's an almost impossible standard to enforce.

Hard disagree on it being fair. If the costs weren't ridiculous, maybe. And pushing the cost onto the taxpayer? Give me a break. This is the most un-empathetic post I've seen on here which is saying. You clearly have not had to personally deal with the hell that is having a loved one get sick in the United States. If you aren't upper class (read as: 1M+ income annually, so maybe 1 or 2 people on this board) then you're choices are: help keep them comfortable and piss all their money / assets away, let them die quick and not comfortably to help the rest of the family, or do what others have suggested.

I want you to think how stupid it sounds to say that getting permanently disabled and saddled with severe medical bills at 40 after having worked two jobs a vast majority of your adult life (and not 'fake jobs' either, one was school teacher which is a whole other issue) which causes your family to file bankruptcy and be left next to destitute, to say that THAT is eminently fair. Really think about it. And if your two brain cells can't realize how stupid it is., then **** off and post less.

[BoomBoom]

Hard disagree on it being fair. If the costs weren't ridiculous, maybe. And pushing the cost onto the taxpayer? Give me a break. This is the most un-empathetic post I've seen on here which is saying. You clearly have not had to personally deal with the hell that is having a loved one get sick in the United States. If you aren't upper class (read as: 1M+ income annually, so maybe 1 or 2 people on this board) then you're choices are: help keep them comfortable and piss all their money / assets away, let them die quick and not comfortably to help the rest of the family, or do what others have suggested.

I want you to think how stupid it sounds to say that getting permanently disabled and saddled with severe medical bills at 40 after having worked two jobs a vast majority of your adult life (and not 'fake jobs' either, one was school teacher which is a whole other issue) which causes your family to file bankruptcy and be left next to destitute, to say that THAT is eminently fair. Really think about it. And if your two brain cells can't realize how stupid it is., then **** off and post less.

Lord knows I rarely agree with J85, but to be fair he was only referring to a single person. It makes some sense, if you are concerned like J85 is about any person anywhere 'undeservedly' getting something for free from the govt. The other school of thought, once minimal but quickly growing in this country, is to stop means testing everything and just give benefits to everyone equally. The rich already paid for it with their taxes, stop obsessing over them getting a public benefit. Conservatives are generally against this because they want govt services to be seen as welfare for the poor, so as to make them unpopular and thus drive support for lower taxes for the rich.

[viverlibre]

Medicaid doesn't necessary take your property after your death to settle the bill. I'm assuming they would have to file some type of legal claim against your estate, a Medicaid Supervisor once told me many times they don't even bother, but you never know. That's why is important to consult an attorney who is knowledge in this area.

A former neighbor investigated nursing home abuse for the State AG, he had some sad and terrible stories. Obviously you want to keep a loved one out of a nursing home as long as possible, but many will end up there at some point. If a loved one does end up in one, it is important to check on him/her as much as possible, which can be very challenging if you have children at home or live far away.

I've instructed my kids to just let me out in the woods if it ever comes to me needing to be put in on.

[Johnson85]

Hard disagree on it being fair. If the costs weren't ridiculous, maybe.Our healthcare costs are ridiculous. That's what happens when you artificially limit supply while subsidizing demand. I wish we wouldn't be so stupid with it, but the way to fix that is to stop pushing stupid policy, not to try to subsidize it more. Medicaid is means tested welfare. It's not supposed to help people preserve assets or pass on assets to family. It's supposed to make sure they are not left on the street when they don't have money.



And pushing the cost onto the taxpayer? Give me a break. This is the most un-empathetic post I've seen on here which is saying. You clearly have not had to personally deal with the hell that is having a loved one get sick in the United States. If you aren't upper class (read as: 1M+ income annually, so maybe 1 or 2 people on this board) then you're choices are: help keep them comfortable and piss all their money / assets away, let them die quick and not comfortably to help the rest of the family, or do what others have suggested.
I actually have had to deal with it with a grandparent. Had my grandfather's health declined quickly instead of slowly, he could have passed on a high six figure inheritance to his children. Instead, he pretty much exhausted his savings on end of life care. I think in general all his children are happy they had more time with him. I've never heard any of them complain that taxpayers didn't pick up the bill so that they could get an inheritance. I've certainly never thought that. Somebody has to pay for end of life care. I wish we didn't make it unnecessarily expensive without improving the quality (most nursing homes that will take medicaid are not where you want to be), but provided we're going to make it expensive, it seems pretty reasonable and empathetic to say people pay for it if they can, and taxpayers pay for it if they can't. It doesn't seem empathetic to me to want other people to pay more taxes so I could inherit more money. Lots of people don't get inheritances. And I suspect that on average, people with parents who could have left them a good sized inheritance except for end of life care probably still start off with a leg up on average, even without the inheritance.


I want you to think how stupid it sounds to say that getting permanently disabled and saddled with severe medical bills at 40 after having worked two jobs a vast majority of your adult life (and not 'fake jobs' either, one was school teacher which is a whole other issue) which causes your family to file bankruptcy and be left next to destitute, to say that THAT is eminently fair. Really think about it. And if your two brain cells can't realize how stupid it is., then **** off and post less. Well, disability at 40 is a little different from what we were talking about, but when somebody becomes disabled and has to rely on the government for care and support, what is the "fair" amount of support they should get? If you provide them the median income, then is that "fair" to the people that are working and making less than the median? If you provide them the income they were making before disability, is that "fair"? Certainly hard work goes a long way, but inherited traits matter a lot too. Is it fair that getting lucky in inherited traits but unlucky in health gets you better income than somebody that is unlucky in inherited traits but lucky in health? What about the person that is lucky in inherited traits but gets unlucky in health before establishing an earnings history? Those don't seem like questions with obvious answers to me, even if you have more than two brain cells. And that's ignoring the incentive problems when you make government aid too generous. Disability pay is not particularly generous right now, and we still have tons of people that pursue fraudulent disability claims so that they can not work and/or work for cash. That's not going to get better or easier to address if disability pay gets more generous.

ETA: And again, I don't think somebody should be made worse off by being married to somebody that needs end of life care. They shouldn't have to give up more than half their nest egg. But while that's an easy enough concept, I don't know how easy it is to put into practice.

[BrunswickDawg]

Lord knows I rarely agree with J85, but to be fair he was only referring to a single person. It makes some sense, if you are concerned like J85 is about any person anywhere 'undeservedly' getting something for free from the govt. The other school of thought, once minimal but quickly growing in this country, is to stop means testing everything and just give benefits to everyone equally. The rich already paid for it with their taxes, stop obsessing over them getting a public benefit. Conservatives are generally against this because they want govt services to be seen as welfare for the poor, so as to make them unpopular and thus drive support for lower taxes for the rich.

Without getting political about it - a major issue is that Medicare and Medicaid are not being used as intended. They were meant as insurer/provider of last resort - so their programs are built around that approach. You HAVE to be indigent qualify. Our political leadership - unable function from any perspective - has allowed the insurance/medical industrial complex to turn Medicaid and Medicare into the defacto providers for everyone over 65 without changing the structures of the program. Think about how broken our system really must be if for the majority of citizens in the country the only option for elder care is give away all of your assets and declaring yourself indigent. And as you can see from multiple posts on this thread - that is the typical experience.

We, as a country, have to do better than this.

[Lord McBuckethead]

Well it does seem like that, the government swoops in when people are the most vulnerable.
The other side of the coin is this, if the government gave zero assistance, what would be the financial outcome of an elderly person going into an assistant living facility with mental cognitive issues? Would the surviving spouse be responsible for the money? Yes they would, until they were bankrupt. Would they then kick the patient out on the street if they couldn't pay, yes they would.

The issue here is simple. One large group of individuals in this country, cannot stand a person getting a benefit for something when they do not meet the needs test for that benefit. We demand as a society that in order to receive government assistance, you cannot exceed some arbitrary benchmarks. This is why there are monetary limits to welfare, basically forcing people not to earn too much money or else they lose benefits. Keeping them on the edge of poverty, because it takes too long to earn a living wage when you start from nothing. The solution here is to offer a time based welfare system. IF you qualify for welfare and get a job to help your family and you exceed the threshold for that benefit, maybe you should be given a couple more years to truly get on your feet before the benefit expires. The flip side of that is that people actively manage their production to make sure they don't lose that benefit and they stay on the system longer.

When it comes to twilight of life issues like this, what would half the country agree is the correct path? Give money to someone that has money to pay for these services, or not? Imagine you have 500k saved for retirement and your wife, age 65, is suffering mental decline. That 500k will be consumed in a matter of 50 months, easily. Not even considering the spouse that is still on the outside trying to survive.

[Lord McBuckethead]

Lord knows I rarely agree with J85, but to be fair he was only referring to a single person. It makes some sense, if you are concerned like J85 is about any person anywhere 'undeservedly' getting something for free from the govt. The other school of thought, once minimal but quickly growing in this country, is to stop means testing everything and just give benefits to everyone equally. The rich already paid for it with their taxes, stop obsessing over them getting a public benefit. Conservatives are generally against this because they want govt services to be seen as welfare for the poor, so as to make them unpopular and thus drive support for lower taxes for the rich.

Yep. Means testing is a major issue with all welfare systems, but dammit if a large portion of our country just cannot stand someone getting something for free when it isn't them or their family. youtube channel 2 cents just had a video on means testing and the welfare system keeping people poor. Almost impossible to break out of the cycle, because at a certain limit that isn't a comfortable living, a person losses so much assistance it is prohibitive for them to grow.

[Johnson85]

Without getting political about it - a major issue is that Medicare and Medicaid are not being used as intended. They were meant as insurer/provider of last resort - so their programs are built around that approach.

Was Medicare ever intended to be an insurer of last resort? They penalize you for not enrolling and to my knowledge, other than getting a more generous subsidy the lower your income, it's not really means tested. Everybody gets it and gets a very subsidized rate, and the amount of the subsidy. I thought it was designed from the beginning, to basically be like Social Security and provide welfare that is not means tested but instead structured to be "progressive".



You HAVE to be indigent qualify. Our political leadership - unable function from any perspective - has allowed the insurance/medical industrial complex to turn Medicaid and Medicare into the defacto providers for everyone over 65 without changing the structures of the program. Think about how broken our system really must be if for the majority of citizens in the country the only option for elder care is give away all of your assets and declaring yourself indigent. And as you can see from multiple posts on this thread - that is the typical experience. That's not the only option. That is a way for people to game the system so they don't have to pay for elder care. I don't doubt that we unnecessarily inflate the cost of assisted living, but I come across people that are pissed because their parents had to spend their $100k nest egg down at the start of their 4 year nursing home stay. However inflated it is, I don't think it's reasonable to think that a $100k nest egg plus social security is going to be able to pay for several years of nursing home care without spending down that $100k.


We, as a country, have to do better than this. That's fine, but people have to be realistic about what it's going to do to people's quality of life over the course of their life if we're going to make assisted living available without requiring people to exhaust their assets first. If you're going to have people work for 40 years and collect enough taxes from them to pay for any needed assisted living without them having to spend down their assets first, that's going to be a significant amount of taxes. There's a reason so few people by long term care insurance. It's really expensive. Certainly we could stop inflating the cost of medical care, but I don't think assisted living is ever going to be cheap as long as we are dependent on people to provide the care. Monitoring and assisting nursing home residents is labor intensive and will presumably continue to get more expensive due to Baumol's cost disease.

Was Medicare ever intended to be an insurer of last resort? They penalize you for not enrolling and to my knowledge, other than getting a more generous subsdiy the lower your income, it's not really means tested. Everybody gets it and gets a very subsidized rate, and the amount of the subsidy. I thought it was designed basically like Social Security, to be more or less welfare that is not means tested?

[Johnson85]

Yep. Means testing is a major issue with all welfare systems, but dammit if a large portion of our country just cannot stand someone getting something for free when it isn't them or their family. youtube channel 2 cents just had a video on means testing and the welfare system keeping people poor. Almost impossible to break out of the cycle, because at a certain limit that isn't a comfortable living, a person losses so much assistance it is prohibitive for them to grow.

That's not really a problem with means testing. It's a problem of us spreading out welfare over dozens of programs and administering them separately. You are going to have pretty high imputed tax rates (>50%) if you phase out benefits over a reasonable income range, but we could easily avoid them approaching 100% if we had central administration for all our welfare benefits and designed them to make sense together.

[Leeshouldveflanked]

Sometimes I think Dr. Kevorkian wasn?t the monster every one made him out to be. Nothing worse than going to some of these nursing homes and seeing people in the shape they are in. He just got to the point where he enjoyed his work a little too much.

[Catfish]

Sometimes I think Dr. Kevorkian wasn?t the monster every one made him out to be. Nothing worse than going to some of these nursing homes and seeing people in the shape they are in. He just got to the point where he enjoyed his work a little too much.

Agree with you, but man, it would be hard to make that decision facing a terminal illness. I don't know if I could do it. Life is precious even though it's temporary.

[viverlibre]

Assisted suicide is common in some European countries, including Switzerland. I believe there's too much money in keeping old people alive for it to gain much traction here.

[chef dixon]

This sucks in general. The healthcare system in this country is so broken from top to bottom. Commercial coverage is designed with a mindset to maximize profits for the executives. They don't give two shits about actual health care of the policy owner. Then once you're 65 you get thrown to the wolves with Medicare (if you're lucky), which doesn't cover 90% of shit people over 65 actually need.

[Bass Chaser]

I will just say there is a huge difference between assisted living facilities and long term care/nursing facilities.

Medicare only pays up to 90 days of care at a facility after that it’s private pay, LTC insurance, or Medicaid. Some facilities will not accept Medicaid.

If you decide on a facility, look for one with memory care.